By Christian Nix

In the fall of 2006, I first met with Juan Manuel Chuc, Guatemalan director of the Hospitalito of Santiago on Lake Atitlan. On the 6^th of August 2008, he was the first patient I treated at the Hospitalito. Having slept fitfully the previous night, Chuc awoke that Wednesday with a wry neck. This is one of the most effortless and infinitely remediable presentations any ‘needle-jockey’ is likely to encounter. It was no surprise therefore when, in the brief window between the Wednesday morning staff-meeting and Chuc’s first surgery of the day, having lay still for 15 minutes while I briefly explained what I was doing and how other treatments would be of similar brevity - Doctor Chuc sat up, took a deep breath, smiled and thanked me with delighted relief, and went to scrub for surgery. Thus began my Community Acupuncture project on Lake Atitlan in Santiago – a town of singular character and uniqueness (it being the city with the largest indigenous population in all of Central America).

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I cite the treatment of the Director of the Hospitalito not because he is representative of the patient population I came to serve, but because the success of any such effort at Integration in medicine can revolve on a single encounter with an influential (albeit skeptical) administrator. (In this case it must be said that while Doctor Chuc has not studied TCM or acupuncture in any form, he was anything but skeptical and was in fact enthusiastic to explore how we might introduce this essential therapeutic modality from the first. In fact, unprompted by and unbeknownst to me, Doctor Chuc grabbed the bull by the horns and, in the week prior to my first full day ‘in clinic’ had created a radio announcement, which was broadcast to the entire town  of about 40,000 during the four days prior to my debut appearance of the Hospitalito.)

The endorsement of an influential administrator can lead to real success; at the least it amounts to the ‘go ahead’ signal to bring one’s skills with confidence. Likewise, their rejection and censure usually means ‘good-luck and try again elsewhere.’

The story of the Hospitalito is a dramatic and triumphal tale. After years of grunt-work and foundation-laying, the Hospitalito opened its doors in July of 2005 in a part of Santiago called Panabaj.  (Panabaj means ‘through the stones’ or ‘in the stones’)  The Hospitalito is a fully equipped Western medical facility staffed by Guatemalan professionals and North American and European volunteer physicians in specialties ranging from family practice to obstetrics to pediatrics to whatever else comes along. For the first time in their history, the Tzutujil people of the once war-ravaged city of Santiago would have for their comfort a no-kidding, Western-style medical facility. (For more on the history of its origin see http://vimeo.com/6422527)  The Hospitalito opened amidst the ceremony and bombast appropriate for such an occasion. That was July.

In October of the same year, all that remained visible of the Hospitalito was the roof. Panabaj had been buried in a mudslide that entombed some 1400 residents in their sleep. Deforestation high upon the slopes of the volcanoes which tower to the south and east of Santiago and its neighborhood of Panabaj ­– coupled with some nine inches of rain which fell in three hours thanks to Hurricane Stan – made away with the lives and hopes of the people of this tragic village during a single night of heart-breaking calamity among a people whose history in the last 50 years includes many such episodes of hardship.

Nonetheless, like a phoenix from the ashes, the Hospitalito reopened within days, having moved to a location at the other end of town and – by extension-cord and candle light – continued the work of tending expectant mothers, the infirm, and the acutely injured and ill of Guatemala’s indigenous population.

Community Acupuncture in a Western Hospital

The Community Acupuncture project is an attempt to augment the care and management of chronic disorders. When I first contacted the Hospitalito, I did so through one of the project’s progenitors and benefactors, doctor Gil Mobly who put me in touch with doctor Leah Abraham, an OB-GYN who was also the acting head of the hospital for the US contingency. Within three minutes of our first face-to-face, I was certain that what I proposed and envisioned could be pulled off. After exchanging the customary niceties of chitchat and polite inquiry, Leah saved me the trouble of getting to the point by stating outright, “What we need is help in treating patients for pain and stress. Drugs are expensive and our supply can be unreliable, since the medications are often donated.  Plus, we (MD’s) are all aware of the effects of keeping patients on (Western pharmaceutical) drugs for long periods, whether for pain or psychiatric conditions.”

I allowed myself a smile at this, as it pre-empted utterly the entire case I had prepared in praise of acupuncture’s efficacy in the treatment of pain and stress. Mentally fast-forwarding, I went straight to the logistical portion of my presentation, explaining to Dr. Abraham how a multitude of patients could be treated simultaneously and in a single setting.

From that meeting to my August 6^th debut, the actualization of this pain and stress acupuncture program has been more or less precisely as I described and envisioned. That first day, I treated – in addition to Chuc’s wry back – a case pf sciatica, a very wet cough (TB is a real issue among the patient population of this part of the world), severe insomnia, depression, externally contracted wind-cold in a man who though I supposed him to be between and 50 and 55, turned out to be 78. The final patient was a young girl with low back pain (whose case I will describe presently). This was all within about a two hour window. Satisfied smiles and relieved countenances exited our salon, which doubles as the doctor’s lounge and boasts a simply unprecedented view, looking-out over the bay of Santiago and one of the prettiest vistas of this glorious, volcano shadowed lake.

In a moment of authentic self-congratulatory reverie, and recounting the toil of the last seven years, I felt like, well, like the person I have sought to become; validated and useful to others.

To illustrate the need for true integration of skill and knowledge and inter-disciplinary collaboration that can occur in settings such as this, I come back to that last patient - a young girl with severe lumbar. The problem presented by this young girl was one handled best not by TCM, but by a simple chiropractic adjustment. Four simple adjustments and one more extremely satisfied patient later, I decided to wrap for the day and review, in thought, what needed improvement for next-week’s foray. The ability to call upon expertise in the application of therapies, in which one is yet inexpert, is a crucial tool in the kit of the integrative specialist.

To be sure, the Gods were smiling upon this debut performance of my Community Acupuncture project. While I did not perform each and every treatment as flawlessly as I would have liked; nonetheless, the first treatment of the day (the hospital director), and the last (the young girl with the sub-luxation in her low back), proved marvelous bookends to the first day’s work in this project - which seems certain to grow.

In review, I agree utterly with the summary account made by Jeanette Painovich, whose program at Good Samaritan Hospital in Los Angeles is, in some ways, the gold-standard for the integration of acupuncture into a Western medical setting. Being prepared, patient and professional, are keys to success. Getting through to the higher-ups, and proving one’s worth and the worth of simple acupuncture treatment is indispensable for a fledgling program. A professional demeanor in all one’s interactions with one’s Western medical counterparts is perhaps the sine qua non for earning the acceptance and the subsequent confidence of one’s Western medical counterparts.

Lastly, those of us in the vanguard of Integration in the Western hemisphere must understand what it means to defer one’s personal gratification in favor of useful, effective collaboration. Already and after the briefest of beginnings, I glimpsed a scenario – a clinical model of delivery – in which the obstacles to cross-modal learning and effective clinical application of Eastern and Western approaches fall away in favor of an open-minded and yet stringently evidence-based approach to medicine. How odd that such a laboratory of learning should emerge at the end of a lake in a nearly forgotten corner of the world, wherein resides one of the planet’s oldest and proudest cultures. Many thanks to all involved - past, present, and future - for the creation of such an opportunity.

Barefoot Medicine Training permit students and practitioners of TCM and other holistic modalities the opportunity to work alongside Western medical physicians, gaining valuable experience in the integration of Eastern and Western medicine, while learning Spanish and experiencing the profound wisdom and simplicity of the ancient Maya people, all situated on Lake Atitlán, one of the most beautiful lakes anywhere in the world.  For more information, please see: http://www.youtube.com/watch?v=QfLiiwWrgQQ

http://www.cieloexternships.com/acupuncture_externship.htm

Christian Nix, MA; L.Ac.

(866) 841-9139 ext. 1011

Email: Info@BarefootMedicineTraining.com